# Molecular Regulation of Breast Cancer Progression

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2022 · —

## Abstract

Background: Cancer of the breast (BrCa) is the most frequent tumor in women, affecting black women most
severely; BrCa is also more prevalent and morbid in military women. Localized primary carcinomas are often
found and removed, curing up to 80% of the women and few men afflicted. Once the cancer has disseminated,
current therapies, even newer biologics and immunotherapies, prolong life for just a few years. Signals and cell
behaviors that enable metastatic survival and outgrowth of disseminated tumors are critical transition points.
 Our investigations during the present and previous Award periods demonstrated that upon dissemination to
the ectopic microenvironment, the parenchymal cells direct the tumor cells to re-express epithelial markers
including the defining E-cadherin. This cell-cell cohesion marker forms heterotypic binding that renders the
tumor cells more resistant to killing by chemotherapies and death cytokines and down-regulate targets of
immunotherapy. This protection from death signals proceeds through E-cadherin-triggered signaling involving
at least the PI3 kinase-AKT pathway with the specific pathways being targeted herein.
 We also investigate that this epithelial reversion also likely leads to tumor cell dormancy, a complication of
tumor dissemination. We have modeled this to demonstrate that quiescence of the entire organ underlies the
dormancy, but that this non-proliferative state is plastic with stimulated cells being `awakened' and regaining an
aggressive mesenchymal phenotype secondary to activation of the supporting nonparenchymal cells by
specific stressors leads to inflammation-triggered outgrowth that will be investigated herein.
Hypothesis: Our foundational model posits that E-cadherin-ligandation signals promote tumor cell dormancy
and survival via select signaling pathways that can be targeted to reverse the chemo-resistance and possibly
immune-escape. By discerning the operative signals and pathways we can develop novel approaches to
micrometastases in targeting the emergent breast cancer cells. The interplay of tumor cells with cells of the
metastatic microenvironment dictates both responsiveness to tumor-targeted therapies and dormancy/
outgrowth. This hypothesis leads to two linked questions – what are the mechanisms that confer the resistance
of metastasis, and why do the tumor cells then later emerge from this dormant stage to grow as lethal tumors.
These topics will lead to novel approaches by which these emergent carcinoma cells will be targeted.
Specific Aims: Two linked but independent aims will be pursued simultaneously:
I. Define the key tumor cell mechanisms that provide for resistance to killing in the micrometastatic
niche and determine if targeting them can enhance chemosensitivity. E-cadherin promotes survival, at
least in part, by signaling via the canonical AKT pathway, with our preliminary data supporting that targeting
these intermediary kinases can abrogate the chemoresistance of metastasi...

## Key facts

- **NIH application ID:** 10427118
- **Project number:** 5I01BX003368-07
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** ALAN WELLS
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2016-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10427118

## Citation

> US National Institutes of Health, RePORTER application 10427118, Molecular Regulation of Breast Cancer Progression (5I01BX003368-07). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10427118. Licensed CC0.

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